title: Operatively induced chronic reflux in rats: a suitable model for studying esophageal carcinogenesis?
abstract: BACKGROUND
  The mechanisms of esophageal reflux leading to esophageal adenocarcinoma (EA) remain poorly understood. This study appraises critically an operatively induced chronic reflux rat model.
  
  
  METHODS
  We randomized 108 Sprague-Dawley rats into 2 experimental groups; one was performing esophagoduodenal (ED) anastomosis with or without gastrectomy to induce duodeno-esophageal reflux (DER group; n = 63), and the other involved duodeno-gastro-esophageal reflux (DGER group; n = 45). Control groups included (i) Roux-en-Y esophagojejunal anastomosis, (ii) laparotomy alone, (iii) subtotal gastrectomy to induce duodenogastric reflux (DGR group), and (iv) the same procedure as in the DGER group plus proton pump inhibition (PPI group). The esophagus underwent histologic and molecular analyses.
  
  
  RESULTS
  The prevalence of Barrett's esophagus (BE), dysplasia, and EA in the experimental groups was 41%, 7%, and 11%, respectively. Histologic and molecular analyses in groups DER, DGER, and DGR suggested that BE occurred through de novo intestinal metaplasia and proximal migration of duodenal cells. No distant metastases were identified. The molecular characteristics of both BE and EA were similar to humans. BE was more common, and dysplasia and EA less frequent in the DER group when compared with the DGER group (44% vs 24% [P = .038] and 7% vs 25% [P = .012], respectively). Compared with the DGER group, carcinogenic sequence occurred less frequently in the PPI-treated group (P = .019).
  
  
  CONCLUSIONS
  Despite pathophysiologic differences with humans, the rat model of esophagoduodenostomy reproduces accurately histologic and molecular lesions in the carcinogenetic sequence of BE and allowed us to identify novel, tumor-associated proteins that may be potential biomarkers and new therapeutic targets in EA.
authors.affiliation: Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 "Mucins, epithelial differentiation and carcinogenesis", Lille, France; Université Lille Nord de France, Lille, France; Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gronnier
authors.forename: Emilie
authors.initials: E
authors.lastname: Bruyère
authors.forename: Guillaume
authors.initials: G
authors.lastname: Piessen
authors.forename: Nicolas
authors.initials: N
authors.lastname: Briez
authors.forename: Jérome
authors.initials: J
authors.lastname: Bot
authors.forename: David
authors.initials: D
authors.lastname: Buob
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.forename: Isabelle
authors.initials: I
authors.lastname: Van Seuningen
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariette
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D000818:Animals; D001471:Barrett Esophagus / Q000150:complications* / Q000473:pathology; D002460:Cell Line; D013505:Digestive System Surgical Procedures; D004195:Disease Models, Animal; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D009752:Nutritional Status; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley